<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Czlx')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-czlx" class="form-control" name="row[czlx]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Gzdw')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-gzdw" class="form-control" name="row[gzdw]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Tel')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-tel" class="form-control" name="row[tel]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lxr')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lxr" class="form-control" name="row[lxr]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Lxrtel')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-lxrtel" class="form-control" name="row[lxrtel]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Xuexing')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-xueXing" class="form-control" name="row[xueXing]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Rhyx')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-rhyx" class="form-control" name="row[rhyx]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Whcd')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-whcd" class="form-control" name="row[whcd]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Zhiye')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-zhiYe" class="form-control" name="row[zhiYe]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Hunyin')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-hunYin" class="form-control" name="row[hunYin]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Yibao')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-yiBao" class="form-control" name="row[yiBao]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ywgm')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ywgm" class="form-control" name="row[ywgm]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Bls')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-bls" class="form-control" name="row[bls]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Jibing')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-jiBing" class="form-control" name="row[jiBing]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Shoushu')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-shouShu" class="form-control" name="row[shouShu]" type="text" value="无">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Waishang')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-waiShang" class="form-control" name="row[waiShang]" type="text" value="无">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Shuxue')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-shuXue" class="form-control" name="row[shuXue]" type="text" value="无">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Jzs')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-jzs" class="form-control" name="row[jzs]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Yichuan')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-yiChuan" class="form-control" name="row[yiChuan]" type="text" value="无">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Canji')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-canJi" class="form-control" name="row[canJi]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Chufang')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-chuFang" class="form-control" name="row[chuFang]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Ranliao')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ranLiao" class="form-control" name="row[ranLiao]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Yinshui')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-yinShui" class="form-control" name="row[yinShui]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Cesuo')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-ceSuo" class="form-control" name="row[ceSuo]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Qinchulan')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-qinChuLan" class="form-control" name="row[qinChuLan]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Dev_no')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-dev_no" class="form-control" name="row[dev_no]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Utime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-utime" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[utime]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Vender_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-vender_id" data-rule="required" data-source="vender/index" class="form-control selectpage" name="row[vender_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
